Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California.
Department of Endodontics, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California; University of Queensland Dental School, UQ Oral Health Center, Herston, Queensland, Australia.
J Endod. 2018 Aug;44(8):1257-1262. doi: 10.1016/j.joen.2018.04.017. Epub 2018 Jun 20.
Reports comparing clinical outcomes using nickel-titanium (NiTi) reciprocating instruments with other instrumentation modalities are scarce. This study examined initial shaping outcomes after an instrumentation change of root canal instrumentation technique in a doctor of dental surgery educational program. Student characteristics, faculty/student ratio, facility, and overall endodontic treatment guidelines remained unchanged.
A total of 200 nonsurgical initial molar root canal treatments completed by third-year dental students were evaluated. The cases were examined regarding the number of treatment appointments, access cavity preparation, canal taper, canal transportation, perforations, missed canals, presence of ledges, fractured instruments, obturation length, obturation quality, and sealer extrusion. Two independent evaluators determined the number of appointments per case; 4 independent and blinded evaluators analyzed radiographs at 4 treatment stages: preoperative situation, working length, cone fit, and obturation.
The following factors were significantly different between the 2 cohorts: the number of appointments, preparation length, taper, and occurrence of ledges. The WaveOne (Dentsply Sirona, York, PA) cohort had a significantly reduced treatment time compared with hand/GT rotary instrumentation (Dentsply Tulsa Dental, Tulsa, OK) (average of 3.3 vs 4.3 appointments). Appropriate length control and adequate taper were significantly more frequent in the WaveOne group. The frequency of ledges was significantly larger in the hybrid group. Other variables, such as access cavity preparation, canal transportation, perforations, missed canals, fractured instruments, obturation quality, and sealer extrusion, were statistically similar between the 2 groups.
NiTi reciprocation instrumentation was superior to hybrid hand/NiTi rotary instrumentation in reducing both patient appointments and the incidence of ledging and in improving obturation length and taper in a dental student clinic setting.
比较镍钛（NiTi）往复式器械和其他器械在临床效果的报告很少。本研究检查了牙科学院教育项目根管器械技术改变后的初始成形效果。学生特征、师生比例、设施和整体牙髓治疗指南保持不变。
共评估了 200 例由三年级牙科学生完成的非手术初始磨牙根管治疗。检查病例的治疗次数、开髓窝洞制备、根管锥度、根管偏移、穿孔、遗漏根管、侧支形成、器械折断、充填长度、充填质量和密封剂挤出情况。两名独立评估者确定每个病例的就诊次数；4 名独立和盲法评估者在 4 个治疗阶段分析 X 线片：术前情况、工作长度、锥度和充填。
两个队列之间有以下因素显著不同：就诊次数、制备长度、锥度和侧支形成。WaveOne（登士柏西诺德，约克，宾夕法尼亚州）组与手动/GT 旋转器械（登士柏图尔萨牙科，塔尔萨，俄克拉荷马州）相比，治疗时间明显缩短（平均 3.3 次与 4.3 次就诊）。WaveOne 组的适当长度控制和足够的锥度更频繁。混合组的侧支形成频率明显更大。其他变量，如开髓窝洞制备、根管偏移、穿孔、遗漏根管、器械折断、充填质量和密封剂挤出，在两组之间统计学上无显著差异。
在牙科学生诊所环境中，NiTi 往复式器械在减少患者就诊次数和侧支形成发生率、改善充填长度和锥度方面优于混合手动/NiTi 旋转器械。
